Many Skiers Who Tear ACLs Can Avoid Surgery, Expert Says

Identifying those patients cuts health costs, recovery time

HealthDay—February 15, 2013

About one-quarter of recreational downhill skiers who suffer anterior cruciate ligament (ACL) injuries can recover without surgery, according to a new study that outlines how to identify these patients.

The ACL is the main, stabilizing ligament of the knee joint.

The researchers looked at 63 people who suffered a first-time skiing ACL tear and found that two tests conducted six to 12 weeks after the injury could identify patients who would recover without surgery. The tests involve physical manipulation of the knee by a doctor.

"Some patients who tear their ACL while skiing can get away without surgery. Their ligament heals by itself, they will have stable knees and they will be able to do whatever they want, including skiing," study leader Dr. Robert Marx, an orthopedic surgeon in the Sports Medicine and Shoulder Service at Hospital for Special Surgery in New York City, said in a hospital news release.

"It is a huge deal to avoid surgery," he added. "For people who are 40 and over and who have less muscle mass, it takes a long time to recover, sometimes a year."

He said identifying patients who can heal without an operation reduces health costs and recovery time.

ACL tears from skiing are often less traumatic than those that occur while playing sports that involve pivoting, such as soccer or football, Marx noted.

The study is published online in the journal Knee Surgery Sports Traumatology Arthroscopy.

"Patients who tear their ACL during recreational skiing should not rush to schedule surgery right after their injury," Marx advised. "They should wait and be reevaluated at six to 12 weeks unless there is some other obvious reason to do surgery like a displaced meniscal tear or other ligament injuries. Most recreational skiers don't have those, and they may be able to avoid surgery if they wait and get re-evaluated."